Non-Drug Approaches for Preventing or Managing Hypertension

Non-Drug Approaches for Preventing or Managing Hypertension

1. Reduce your weight
Keeping your weight at a reasonable level is the single most important modifiable factor in the prevention of hypertension in our society (particularly among overweight hypertensive patients).

2. Exercise regularly
Existing data suggest that low-intensity (between 50-70% of VO2max) aerobic exercise performed on a regular basis reduces the likelihood that a person will develop hypertension. Regular low-intensity exercise also lowers the systolic blood pressure (average reduction of 10 points (mm HG)) and diastolic blood pressure (8 points) in hypertensive patients. Recent evidence also indicates that the circuit-type weight training produces a mild to moderate BP-lowering effect in people with mild hypertension.

3. Restrict salt intake
Dietary salt reduction has been shown to lower blood pressure (BP) in some salt-sensitive - but not all - individuals. Lowering the amount of salt in an individual's diet tends to be a more effective treatment for older, black, or more severely hypertensive patients.

4. Limit consumption of alcohol
Several cross-sectional studies have shown an association between high alcohol intake and elevated BP. In people with hypertension, alcohol consumption causes increases in BP and interferes with the effectiveness of drug therapy.

5. Manage your stress
Stress-management techniques such as biofeedback, relaxation training, and yoga have all produced modest BP decreases (4-6 points) in some mildly hypertensive patients.

6. Increase your intake of calcium
Numerous epidemiological studies have demonstrated that an inverse relationship exists between dietary calcium intake and BP. Furthermore, intervention studies have shown that increased dietary calcium consumption (a daily calcium consumption between 800-1200 milligrams, which is within the range of the RDA for calcium) produces modest reductions (4-6 points) in the BP of some people with high blood pressure.

7. Increase your intake of potassium
A growing number of controlled studies have documented a modest BP-lowering effect (5-7 points) of increased potassium intake in people with mild hypertension, particularly among blacks. On the other hand, individuals with impaired kidney function, the elderly, or patients receiving certain anti-hypertensive medications should not excessively increase (exceeding 6000 mg/day) their potassium intake.

8. Increase your intake of fiber
Plant fiber given alone or in combination with a low-fat, low-sodium diet has been observed to lower BP in hypertensive people by an average of 4-8 points.

9. Increase your intake of magnesium
Initial research studies suggest that a low dietary intake of magnesium is associated with an increased risk for hypertension.

10. Stop smoking
While no evidence exists that cigarette smoking causes long-term increases in BP, compelling evidence is available that smoking increases a hypertensive patient's risk for a heart attack or stroke. Also, it has been clearly established that cigarette smoking reduces the effectiveness of other anti-hypertensive therapies.

James A. Peterson, Ph.D., FACSM, is a freelance writer and consultant in sports medicine. From 1990 until 1995, Dr. Peterson was director of sports medicine with StairMaster. Until that time, he was professor of physical education at the United States Military Academy.

Copyright 2010 by the American College of Sports Medicine.